In an Emergency Setting, What Is the Best Intramuscular Pharmacological Treatment to Give to an Agitated Geriatric Patient?

Abstract

Herein, we describe an agitated geriatric patient who suffered an adverse outcome due to treatment for agitation in an emergency setting. This led to the prompt review of the current literature on best-practice medication to use in this population. After careful review, the authors recommend olanzapine as the first-line medication for agitation due to its lower risk-averse effect profile when compared to other medications used for this patient population.

Characterizing PRN Use of Psychotropic Medications for Acute Agitation in Canadian Long-Term Care Residents with Dementia Before and During COVID-19

“…In general, the prescription and administration of PRN injections of antipsychotics and benzodiazepines in acutely agitated patients may vary by clinician, institutionspecific policies, and availability of pharmacological agents [24,28]. A pitfall of this, as noted by a recent case study, is that clinicians may give undue preference to older, more familiar medications even in situations where newer agents may be more suitable [29]. As such, further research is needed to clarify some of the ambiguity surrounding current practices in the administration of PRN psychotropics for dementia-associated agitation.…”